Phase II, Multicenter, Single-arm Trial of Eribulin as First-line Therapy for Patients With Aggressive Taxane-pretreated HER2-Negative Metastatic Breast Cancer: The MERIBEL Study

Clin Breast Cancer. 2019 Apr;19(2):105-112. doi: 10.1016/j.clbc.2018.12.012. Epub 2018 Dec 20.

Abstract

Background: Eribulin has efficacy in patients with progression after ≥ 1 chemotherapeutic regimen for metastatic breast cancer (MBC). A short disease-free interval (DFI) and previous use of taxanes in the neoadjuvant or adjuvant setting have been associated with worse outcomes for patients receiving first-line chemotherapy for HER2-negative MBC. The aim of the present trial was to evaluate the efficacy and safety of eribulin as first-line therapy for patients with HER2-negative MBC with these poor prognostic factors.

Patients and methods: Eribulin monotherapy was administered until disease progression or unacceptable toxicity. The principal selection criteria were HER2 negativity without previous chemotherapy for MBC, the previous use of taxanes for early-stage breast cancer, and a DFI of < 36 months (subsequently amended to 48 months). The primary endpoint was the investigator-assessed time to progression. The secondary endpoints included overall survival, progression-free survival, objective response rate, clinical benefit rate, duration of response, and toxicity profile. A total of 53 patients were enrolled and received ≥ 1 dose of eribulin.

Results: The median patient age was 47 years (range, 23-82.8 years). The median DFI was 15.7 months (range, 0.1-46.4 months). The median investigator-assessed time to progression was 4.1 months (range, 0.2-27.8 months; 95% confidence interval, 3.2-6.2 months). The objective response and clinical benefit rate was 20.8% and 26.4%, respectively. All-grade and grade 3/4 adverse events developed in 96.2% and 69.8% of patients, respectively. The most common treatment-related adverse events were neutropenia, leukopenia, alopecia, nausea, and anemia.

Conclusion: Eribulin is effective and safe as first-line therapy for aggressive taxane-pretreated HER2-negative MBC.

Keywords: Aggressive taxane-pretreated patients; Eribulin; First-line chemotherapy; HER2-negative; Metastatic breast cancer.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimitotic Agents / adverse effects
  • Antimitotic Agents / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Bridged-Ring Compounds / pharmacology
  • Bridged-Ring Compounds / therapeutic use
  • Drug Resistance, Neoplasm / drug effects
  • Female
  • Furans / adverse effects
  • Furans / therapeutic use*
  • Humans
  • Ketones / adverse effects
  • Ketones / therapeutic use*
  • Middle Aged
  • Neoplasm Metastasis
  • Receptor, ErbB-2 / metabolism
  • Taxoids / pharmacology
  • Taxoids / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Antimitotic Agents
  • Antineoplastic Agents
  • Bridged-Ring Compounds
  • Furans
  • Ketones
  • Taxoids
  • taxane
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • eribulin